1. Field of the Invention
The subject invention is directed to laparoscopic surgery, and more particularly, to a self-adjusting pneumatically sealed trocar for use with an insufflation and gas recirculation system used during laparoscopic surgical procedures.
2. Description of Related Art
Laparoscopic or “minimally invasive” surgical techniques are becoming commonplace in the performance of procedures such as cholecystectomies, appendectomies, hernia repair and nephrectomies. Benefits of such procedures include reduced trauma to the patient, reduced opportunity for infection, and decreased recovery time. Such procedures within the abdominal (peritoneal) cavity are typically performed through a device known as a trocar or cannula, which facilitates the introduction of laparoscopic instruments into the abdominal cavity of a patient.
Additionally, such procedures commonly involve filling or “insufflating” the abdominal (peritoneal) cavity with a pressurized fluid, such as carbon dioxide, to create what is referred to as a pneumoperitoneum. The insufflation can be carried out by a surgical access device (sometimes referred to as a “cannula” or “trocar”) equipped to deliver insufflation fluid, or by a separate insufflation device, such as an insufflation (veress) needle. Introduction of surgical instruments into the pneumoperitoneum without a substantial loss of insufflation gas is desirable, in order to maintain the pneumoperitoneum.
During typical laparoscopic procedures, a surgeon makes three to four small incisions, usually no larger than about twelve millimeters each, which are typically made with the surgical access devices themselves, typically using a separate inserter or obturator placed therein. Following insertion, the inserter is removed, and the trocar allows access for instruments to be inserted into the abdominal cavity. Typical trocars often provide means to insufflate the abdominal cavity, so that the surgeon has an open interior space in which to work.
The trocar must provide a means to maintain the pressure within the cavity by sealing between the trocar and the surgical instrument being used, while still allowing at least a minimum freedom of movement of the surgical instruments. Such instruments can include, for example, scissors, grasping instruments, and occluding instruments, cauterizing units, cameras, light sources and other surgical instruments. Sealing elements or mechanisms are typically provided on trocars to prevent the escape of insufflation gas. Sealing elements or mechanisms typically include a duckbill-type valve made of a relatively pliable material, to seal around an outer surface of surgical instruments passing through the trocar.
SurgiQuest, Inc., Milford, Conn. USA has developed surgical access devices that permit access to an insufflated surgical cavity without conventional mechanical seals, as described in whole or in part in commonly assigned U.S. Pat. No. 7,854,724 and U.S. Pat. No. 8,795,223, the disclosures of which are both incorporated herein by reference in their entireties.
Trocars for laparoscopic surgery are not typically provided with a facility for anchoring to the abdominal wall, and therefore can be accidentally removed therefrom during a procedure. Although some solutions to that problem have been developed, such a means for securing a trocar housing with suture anchors, such devices have been unreliable, cause unnecessary tissue trauma and can be expensive to manufacture.
A novel solution is disclosed in commonly assigned U.S. Pat. No. 7,806,870, the disclosure of which is incorporated herein by reference in its entirety. In the '870 patent, a surgical access device is described that includes a deformable elastomeric outer sheath that anchors the device to the abdominal wall from within the abdominal cavity.
There remains, however, a need in the art for a surgical access device that does not utilize conventional mechanical seals to prevent the escape of insufflating gas from the abdominal cavity, while also having an effective anchoring system to secure the device to the abdominal wall of a patient in an atraumatic manner that prevents accidental removal of the device during a surgical procedure. The present invention provides a novel solution.